Pancreatitis is a condition where the pancreas becomes inflamed. The pancreas is an organ located behind the stomach that produces enzymes to digest food and hormones like insulin to regulate blood sugar. There are two main types of pancreatitis: acute and chronic. Acute pancreatitis involves sudden inflammation that improves within a few days with treatment. Chronic pancreatitis is persistent inflammation that leads to permanent pancreatic damage over time. Living with pancreatitis can be challenging and requires making lifestyle adjustments to manage symptoms and prevent complications.
What are the symptoms of pancreatitis?
The most common symptoms of acute and chronic pancreatitis include:
- Upper abdominal pain that radiates to the back
- Nausea and vomiting
- Fever
- Rapid pulse
- Tenderness when touching the abdomen
The abdominal pain associated with pancreatitis is often severe, sudden, and felt as a steady ache in the upper abdomen that lasts for hours or even days. The pain may be worse after eating and sometimes radiates to the back. Nausea and vomiting commonly accompany the abdominal pain.
In chronic pancreatitis, symptoms tend to be persistent but have periods where they improve or worsen. Ongoing inflammation can destroy pancreatic tissue over time leading to malabsorption of food, weight loss, greasy stools, and diabetes as the pancreas loses its ability to produce digestive enzymes and insulin.
What causes pancreatitis?
Common causes leading to inflammation of the pancreas include:
- Gallstones – One of the most common causes is gallstone obstruction of the pancreatic duct.
- Alcohol use – Heavy alcohol use over many years is another major cause of pancreatitis.
- High triglycerides – Having severely elevated blood triglyceride levels can trigger an attack.
- Certain medications – Some drugs including certain antibiotics and cancer medications can induce pancreatitis.
- Abdominal surgery – Pancreatitis can occur after abdominal or pancreatic surgery.
- Inherited disorders – Rare genetic mutations that affect pancreatic function can increase risk.
- Autoimmune disease – The immune system attacks the pancreas as occurs in autoimmune pancreatitis.
In many cases of acute pancreatitis, no cause is found. But factors that make an attack more likely include smoking, obesity, diabetes, and a high-fat diet.
How is pancreatitis diagnosed?
If pancreatitis is suspected based on symptoms, doctors use several methods to confirm the diagnosis:
- Blood tests – Blood tests look for elevated levels of pancreatic enzymes including amylase and lipase as these leak into the bloodstream from the inflamed pancreas.
- Imaging tests – Ultrasound, CT scan, or MRI of the abdomen may show an enlarged pancreas or inflammation. They help rule out gallstones or tumors obstructing the pancreatic duct.
- ERCP – Endoscopic retrograde cholangiopancreatography (ERCP) involves passing a tube down the throat into the pancreas. It allows injection of contrast dye to see abnormalities on x-rays.
- Biopsy – Rarely, a biopsy of pancreatic tissue may be taken to examine microscopic changes.
These tests allow doctors to confirm the pancreatitis diagnosis and determine the underlying cause.
How is acute pancreatitis treated?
Treatment of an acute pancreatitis attack focuses on:
- Pain management – Strong pain medications like morphine are often needed to control the abdominal pain.
- IV fluids – Fluids and electrolytes are given through the vein to prevent dehydration.
- Bowel rest – No food or drinks are allowed at first to rest the pancreas.
- Nutrition – Nutritional support is provided through feeding tubes or IV nutrition once symptoms improve.
Most people recover within a week with this supportive medical treatment. But severe cases may require treatment in the intensive care unit. Complications like infected pancreatic tissue, pancreatic cysts, or organ failure can sometimes occur.
Removing the underlying cause can help prevent further attacks. So people with gallstone-related pancreatitis may need their gallbladder removed. And stopping alcohol use and triglyceride-lowering medications can prevent recurrences.
How is chronic pancreatitis treated?
Treatment goals for chronic pancreatitis include:
- Relieving pain – Medications or nerve blocks may be used to control constant pain.
- Enzyme supplementation – Pancreatic enzyme replacement pills are taken with meals to improve digestion and nutrient absorption.
- Diabetes management – Insulin or other medications control diabetes caused by impaired insulin production.
- Diet changes – Eating small frequent low-fat meals prevents worsening symptoms.
- Surgery – Procedures like a pancreatic duct drainage operation or pancreatectomy may be done if other treatments fail.
Quitting smoking and alcohol are also recommended to prevent more damage. Even with treatment, chronic pancreatitis is a progressive condition leading to pancreatic insufficiency over time.
What is the outlook for people with pancreatitis?
The prognosis for acute pancreatitis is generally good with fluid resuscitation and other supportive care. Mild cases usually resolve within 1-2 weeks. The prognosis is worse if organ failure, pancreatic necrosis, or other major complications develop.
Chronic pancreatitis tends to get progressively worse over time. Frequent painful attacks and permanent pancreatic damage can occur. This eventually leads to malnutrition, diabetes, and other problems in severe cases. Stopping alcohol use and managing other risk factors can help slow the progression of chronic pancreatitis.
Here is a table summarizing the prognosis for acute vs chronic pancreatitis:
| Type | Prognosis |
|---|---|
| Acute pancreatitis | Usually resolves within 1-2 weeks with proper treatment. Severe cases can lead to life-threatening complications. |
| Chronic pancreatitis | Tends to worsen over time and lead to permanent pancreatic damage. Quitting alcohol and managing other risk factors helps slow progression. |
How does pancreatitis affect day-to-day life?
Living with pancreatitis often involves making lifestyle changes to prevent attacks, control symptoms, and reduce complications. Some ways pancreatitis can impact daily life include:
- Dietary changes – Low-fat foods may be recommended to prevent attacks. Smaller meals spread throughout the day may help manage weight loss and nutrients.
- Taking pancreatic enzyme supplements – Enzyme pills with meals help digest food if the pancreas cannot produce enough.
- Diabetes management – Monitoring blood sugars, taking insulin, and maintaing a diabetic diet.
- Pain and nausea – Frequent or daily pain issues and feeling unwell make work and activities difficult.
- Hospital visits – Repeated hospitalizations are sometimes needed for pain, IV fluids, or other acute care.
- Abstaining from alcohol – Not drinking alcohol helps prevent attacks especially with chronic pancreatitis.
These impacts can significantly reduce quality of life. Working with a gastroenterologist and following their treatment recommendations helps people better manage this challenging condition.
What emergency symptoms require urgent medical care?
People with pancreatitis should seek emergency medical care for these symptoms:
- Severe or worsening abdominal pain
- Fever over 101 F (38.3 C)
- Difficulty breathing or shortness of breath
- Blue skin discoloration (cyanosis)
- Abdominal bloating or swelling
- Dizziness, fainting, or feeling lightheaded
- Nausea or vomiting that prevents keeping down liquids
These signs can indicate a severe attack, serious complication like a pancreatic cyst or abscess, dehydration, or other issues needing hospital care. Urgent evaluation and treatment may help prevent life-threatening problems.
What steps can you take to live well with pancreatitis?
Making certain lifestyle adjustments and following your doctor’s recommendations can help people live well with pancreatitis by preventing attacks and reducing symptoms:
- Take all prescribed medications and enzymes as directed.
- Follow the recommended diet for pancreatitis – low fat, smaller frequent meals.
- Stop smoking cigarettes and avoid secondhand smoke.
- Avoid drinking alcohol completely.
- Reduce dietary fat by choosing lean meats, lowfat dairy, and limiting fried foods.
- Drink plenty of fluids to stay hydrated.
- Report worsening symptoms early before they become severe.
- Attend regular follow up visits and get recommended screening tests.
Being adherent with your treatment plan helps reduce the impacts of pancreatitis and prevent disability over time. Support groups can also provide great advice for living well with this condition.
What should you ask your doctor about managing pancreatitis?
Important questions to ask your gastroenterologist or healthcare provider about managing pancreatitis include:
- What caused my pancreatitis? How can I prevent future attacks?
- What diet changes do you recommend?
- Should I take pancreatic enzyme supplements? When and how much?
- How often should I follow up for reassessment?
- Are there any tests or screening I should have done regularly?
- When should I go to the emergency room?
- Is my condition likely to get worse over time?
- Are there any clinical trials or newer treatments I could try?
Discussing concerns, asking questions, and voicing your priorities helps engage your healthcare team in shared decision making about your treatment plan.
Conclusion
Living with pancreatitis involves managing a chronic condition that can significantly impact quality of life. Acute attacks cause severe abdominal pain requiring hospitalization in many cases. Chronic pancreatitis leads to persistent digestive issues and potentially disability over time.
Making appropriate lifestyle changes and following your doctor’s recommendations helps prevent attacks, control symptoms, and slow disease progression. This includes taking pancreatic enzyme supplements, modifying your diet, managing diabetes, and completely avoiding alcohol.
With proper treatment and vigilant monitoring for complications, many people with pancreatitis can manage this condition and live full lives. Working closely with your healthcare team is key to successfully coping with and treating your pancreatitis.